The investigation stage: what your regulator is doing — and what you should do

During a fitness to practise investigation, your regulator gathers documents, witness statements and — where needed — expert evidence to build the file that decision-makers will rely on. You will be invited, but not usually obliged, to respond. The stage ends when the completed file goes to case examiners. What you do now shapes everything that follows.

This page is part of the free FtP Navigator, our free knowledge hub on every stage of the fitness to practise process.

What happens during a fitness to practise investigation?

A fitness to practise investigation is the evidence-gathering stage: the regulator collects documentary evidence, speaks to those involved and builds the case file that its decision-makers will later consider. Your case reaches this stage after screening has decided the concern needs looking into.

Using the Nursing and Midwifery Council (NMC) as the worked example throughout this page, the investigation will usually begin with the regulator seeking documentary evidence of the factual issues and speaking to the people involved. The NMC says it will not just focus on your actions: it also tries to understand the context in which you were working, applying a set of eight guiding principles whenever it looks into a concern.

The regulator continually reassesses what the incoming information is telling it, whether the level of risk has changed and what further investigative steps are needed. Importantly, the NMC acknowledges that if it cannot obtain the information or documentation it needs, or key witnesses will not assist, it is likely the case examiners will conclude the concerns are not capable of being proved.

What evidence will your regulator gather?

Your regulator will gather whatever relevant, reasonable and proportionate evidence it needs — and in NMC cases it has a legal power, under Article 25(1) of the Nursing and Midwifery Order 2001, to require anyone other than you to provide information and documents. Here is what that typically looks like in practice.

Evidence	Where it comes from	What you should know
Your response and context form	You, at the start and end of the investigation	Voluntary — but early, well-judged engagement can narrow the case and open up softer outcomes
Witness statements	Colleagues, patients, managers — compellable under Article 25(1) (NMC)	Statements carry a statement of truth; copies are sent to you
Employer records and local investigation material	Your employer, the referrer	Requests must be relevant, reasonable and proportionate — but this material can and will be used
Health evidence	Your GP, occupational health or treating specialist — with your agreement	The regulator may also ask you to attend a medical examination with an expert doctor, or testing
Language assessment results	IELTS (or OET) assessment the regulator directs and pays for	Results usually due within around 60 days; failure to comply lets the panel draw adverse conclusions under Rule 31(6A) of the NMC (Fitness to Practise) Rules 2004
Independent expert reports	Instructed experts with no connection to either side	Used for specialised or technical issues, disputed facts, health cases and causation questions
Third-party materials	Police, coroner’s inquests, other regulators, employers	Panels cannot adopt another body’s findings wholesale, but often rely on the same underlying evidence

Where a patient has died or suffered serious harm, the NMC will only add a charge of causing that outcome where there is clear evidence of factual causation — on a “but for” or loss-of-a-real-chance-of-survival basis — and that a reasonable and competent professional would have foreseen the risk. Proving causation allows the full story of the misconduct and its consequences to be told (R (El-Baroudy) v General Medical Council [2013] EWHC 2894 (Admin)), so expect expert evidence and inquest material to feature heavily in these cases.

Do you have to give a statement to your regulator?

No — the NMC is explicit that you do not have to respond to the concerns at these points, or at all during the investigation; but staying silent carries real costs, so treat the decision as strategic, not automatic. Whatever you decide about responding, you still have a duty under the Code to cooperate, including telling the regulator where you are working.

There are strong reasons to respond — carefully, and with advice. The NMC says a detailed early response helps focus the investigation on what is genuinely in dispute, prompts the regulator to follow up contextual lines of enquiry it would otherwise miss, and makes it more likely you can show insight and strengthened practice. Bluntly, if you send no response, outcomes such as undertakings, warnings or advice “won’t be appropriate” — leaving referral to a hearing as the likelier route.

There are also traps. Your response may be shared with the person who raised the concern, especially a patient or family member, and anything inconsistent with what you said to your employer or the police can be exposed later. In health cases, failing to cooperate can itself become an added regulatory concern unless the failure is linked to the health condition. Our NMC defence solicitors review draft responses every week — do not send yours unchecked.

Can your employer’s or the police’s investigation be used against you?

Yes — regulators routinely obtain and rely on material generated by employer disciplinaries, police investigations and inquests, and they may deliberately pause their own case to wait for it. The NMC identifies four situations where a parallel investigation affects its own: where its work risks prejudicing the other investigation (most likely with prosecuting bodies such as the police, SFO or HSE); where it is impractical to proceed (for example, the police have seized all the records); where it is more efficient to wait and reuse the evidence gathered; and where the other outcome is likely to affect its own fitness to practise decision.

An employer investigation is the clearest example of the “efficiency” route: if your employer has already interviewed the witnesses, the regulator may simply wait and use that material. It may also matter substantively — if you address the problems under your employer’s guidance, that can influence whether the regulator takes the case further at all. The practical lesson is that every account you give, in any forum, may end up in the regulatory file: keep them accurate and consistent.

Even if a parallel process leads the regulator to close or hold your case, do not assume it is over. The NMC takes care to avoid giving the impression a matter has been finally dealt with, and it can reconsider allegations when new information surfaces, including the outcomes of other investigations.

How long does a fitness to practise investigation take?

There is no fixed deadline: regulators say investigations should begin without delay, but the real timescale is driven by case complexity, expert evidence, witness cooperation and — above all — parallel proceedings. A case held behind a police prosecution or a major systemic inquiry can be delayed for a long time, most often being paused at the point it is ready for case examiners.

A delayed case is not a dormant one. The regulator should keep in proactive contact with the other organisation, keep assessing risk on any new information, and keep any interim order under review — or apply for one if the risk picture changes. For a regulator-specific worked example of timescales, see our guide to how long a GMC investigation takes.

What should you do — and not do — during the investigation?

The professionals who come through investigations best are those who engage early, stay consistent and take advice before every significant step. Use this checklist.

Do:

• Take specialist advice before responding — your first 30-minute consultation with us is free
• Tell the regulator where you are working and about any arrangements to provide professional services (a Code duty)
• Respond early and in detail once advised, raising contextual factors at the start — not the end
• Gather and keep evidence of insight, reflection, training and strengthened practice
• Keep your accounts consistent across employer, police and regulatory processes
• Comply with directions (medical examinations, language assessments) or take urgent advice if you cannot

Don’t:

• Ignore regulator correspondence or miss stated deadlines
• Fire off an angry, unchecked same-day response — it may be shared with the referrer
• Save relevant context for the end of the investigation, when it is usually too late to be looked into properly
• Refuse a directed language test without advice — the panel can treat non-compliance as evidence against you
• Assume a case closed during a parallel investigation is finally over
• Forget that in health cases, unexplained non-cooperation can become a fresh regulatory concern

What happens at the end of the investigation?

The investigation stage ends when the regulator gives you a final opportunity to respond to the evidence and passes the completed file to its case examiners. In NMC cases you are asked for a response at the start of the investigation and again at the end — the second invitation is your last chance to influence the file before decisions are made.

The case examiners then decide whether there is a case to answer and how it should be resolved: no further action, advice, a warning, undertakings, or referral to the Fitness to Practise Committee. Remember two points from above: if the regulator could not obtain the key evidence, the case examiners are likely to find the concerns incapable of proof; and if you never responded, the consensual outcomes are off the table. What case examiners do, and how to persuade them, is covered in the next Navigator page on case examiners.

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This page is general information, not legal advice. No liability is accepted for reliance on it. Rules and guidance change — always check the current position or take specialist advice.